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Purpose: Previous meta-analysis studies concluded that static stretching intervention cannot decrease all-cause injury in healthy active individuals. On the other hand, static stretching intervention may decrease muscle injury, but the evidence has not been integrated. The aim of this study was to systematically review the papers and analyze the preventative effects of static stretching intervention on muscle and tendon injuries in healthy active participants. Methods: A computerized search of PubMed, Web of Science, and EBSCO was performed in June 2023. Randomized controlled trials with static stretching investigations to prevent muscle and tendon injuries were included. Results: Of 5575 papers identified, 4 papers were included (three papers examined both muscle and tendon injuries, and one paper examined only tendon injuries). For muscle injuries, the result of the meta-analysis showed that the static stretching intervention group significantly decreased muscle injuries compared to the control group (odds ratio = 0.37; 95% confidence interval, 0.16–0.85; p < 0.01; I2 = 63%). For tendon injuries, it was found that there was no significant difference between the static stretching intervention group and the control group (odds ratio = 0.57; 95% confidence interval, 0.25–1.33; p = 0.194; I2 = 63%). Conclusions: These data indicated that static stretching intervention can prevent muscle injuries, but not tendon injuries, in healthy active participants. [ABSTRACT FROM AUTHOR]

Purpose: This scoping review aimed to identify and synthesize published studies on physical activity (PA) and cognition among persons with cancer and elucidate knowledge gaps. Methods: Articles were identified through electronic and manual searches (02/21 and 03/22) using the following inclusion criteria: (1) empirical, peer-reviewed publication in English, (2) sample comprised persons with cancer, and (3) reported at least one statistical association between PA and cognition. Multiple reviewers independently performed study selection and data extraction, and results were mapped in tabular and narrative form. Results: Ninety-seven articles were eligible; these were largely published from 2017 to 2022 (54.6%), conducted in high-income countries (96.9%), and presented (quasi-)experimental studies (73.2%). Samples predominantly comprised women with breast cancer (48.5%), and recruitment often occurred post-treatment (63.9%). PA interventions included: aerobic (32.3%), resistance (4.8%), combined aerobic/resistance (38.7%), mind-body (19.4%), or other PA (4.8%). Most (66%) articles reported inconclusive findings; 32% were positive (in support of PA promoting cognition or vice versa), and 2.1% were negative. Diverse samples and studies with long-term follow-up were scarce. Conclusions: The state of knowledge is insufficient and more rigorous, large-scale studies are required to provide definitive conclusions about the cognitive benefits of PA among persons with cancer. Implications for cancer survivors: Cancer-related cognitive impairment (CRCI) thwarts quality of life. This review summarizes what is known about the association between PA and cognition among persons with cancer and concludes that the evidence is currently equivocal. Hence, it remains uncertain if PA interventions can reduce CRCI, and large-scale PA intervention trials explicitly designed to promote cognition are greatly needed. [ABSTRACT FROM AUTHOR]

This study aimed to observe the characteristics of foot posture asymmetry and abnormal gait in patients with unilateral and bilateral knee osteoarthritis (KOA) and to explore the association between foot posture asymmetry, abnormal gait and the clinical symptoms and severity of KOA. Sixty patients with KOA were allocated as follows: unilateral group (UG; n = 30) and bilateral group (BG; n = 30). We accessed foot posture, foot posture asymmetry, gait and plantar pressure parameters and symmetry index, clinical symptom-related scores and disease severity, and investigated the relationship between these variables. The results showed that the overall percentage of asymmetry and severe asymmetry in foot posture were lower in BG than in UG. There was substantial asymmetry in many gait indicators within the two groups, but no significant differences were observed between the two groups. Moreover, foot posture asymmetry, multiple gait and plantar pressure parameters and symmetry indices were closely related to clinical symptoms and disease severity. In conclusion, both unilateral and bilateral KOA patients have foot posture asymmetry and gait asymmetry, but the foot posture asymmetry of the former is more severe than that of the latter. Intervention for this population should treat simultaneously both knee joints. The evaluation and monitoring of foot posture asymmetry, gait and plantar pressure parameters and symmetry indices can provide a more comprehensive and scientific basis for the prevention and treatment of KOA. [ABSTRACT FROM AUTHOR]

Background: Running is a widely practiced sport worldwide associated with a host of benefits on cardiovascular, metabolic, musculoskeletal, and mental health, but often leads to musculoskeletal overuse injuries. The prescription of a foot orthosis (FO) is common to manage musculoskeletal impairments during physical activity or functional tasks. Although FOs are frequently prescribed by clinicians for symptomatic populations of runners, the existing literature supporting the prescription of FOs in runners has predominantly focused on either uninjured individuals or a mix of uninjured and symptomatic populations. Thus, the effects of FOs on the treatment and/or prevention of overuse running injuries need to be investigated to guide future research and assist clinicians in their decision-making process. Main body: This scoping review aimed to evaluate the immediate and long-term effects of FOs on lower limb biomechanics, neuromuscular parameters, and pain and disability in symptomatic runners, and to identify factors that may influence the effects of FOs. Five databases (CINAHL, SPORTDiscus, MEDLINE, Embase, and Web of Science) were searched, resulting in 2536 studies. A total of 30 studies, published between 1992 and 2023 (730 symptomatic runners), were included following the removal of duplicates and the screening process. Wearing FOs while running is related to an immediate and a long-term decrease in pain and symptoms of overuse running injuries. Also, wearing FOs while running decreases eversion at the foot/ankle complex, leads to a more lateral plantar pressure at the heel and forefoot, and may change running motor control strategies. Finally, the effectiveness of FOs is influenced by its added features. Conclusions: This study provides recommendations for future research such as the need for standardized methods in describing FOs, considering participant characteristics such as foot morphology, and comparing different types of FOs. Also, this scoping review provides valuable insights for guiding the prescription and design of FOs, and suggests that integrating FOs into a comprehensive treatment plan may yield better results than standalone first-line treatments. Nonetheless, this scoping review highlights the need for future research to explore the optimal integration of FOs into injury-specific treatment plans. Key Points: Foot orthoses may redistribute loads onto non-injured structures, thereby resulting in an immediate decrease in pain and potentially contributing to the treatment of injuries. A rearfoot medial wedge decreases rearfoot and/or calcaneal eversion motion and moments in injured runners. A foot orthosis integrated into a comprehensive treatment plan may yield better results compared to standalone first-line treatments. The use of sham/flat insoles as a control/blinding condition is crucial in evaluating the effect of a foot orthosis. [ABSTRACT FROM AUTHOR]

Purpose: Static stretching (SS) improves flexibility but may impair the accuracy of joint position sense. Therefore, this study aimed to investigate the acute effects and time course of SS on the accuracy of joint position sense, range of motion (ROM), and muscle–tendon unit (MTU) stiffness. Methods: This study randomly assigned 16 healthy, young males to the SS and control conditions. SS intervention in the SS condition was performed on the plantar flexors of the dominant leg for three sets of 60 s. The participants were instructed to sit for 240 s in the control condition. The ankle dorsiflexion (DF) ROM, passive torque at DF ROM, MTU stiffness, and joint position sense on the dominant leg side were measured before (PRE) and immediately (POST) and at 5, 10, and 20 min postintervention. Results: A significant interaction effect was observed in the relative error in the joint position sense, and significant increases were noted in POST compared to PRE in the SS condition. Further, significant interactions were observed in DF ROM, passive torque at DF ROM, and MTU stiffness. The SS condition demonstrated significant increases in DF ROM and passive torque at DF ROM compared to PRE with POST, 5 min, and 10 min, and MTU stiffness significantly decreased in POST compared with PRE. Conclusion: Our results indicated that the accuracy of the joint position sense decreased immediately after SS, but returned to baseline in a very short time. [ABSTRACT FROM AUTHOR]

Purpose: Musculotendinous stiffness (MTS) measurement is valuable for assessing stretch-induced effects for sports injury prevention. There is no consensus on whether there are sex-related differences in MTS reduction by stretching, and no effective stretching protocol exists. We aimed to investigate the sex-related differences in stretch-induced MTS changes. Methods: Fifteen healthy men (22.0 ± 1.0 years) and fifteen healthy women (22.3 ± 1.1 years) performed stretching of the ankle plantar flexors for four sets of 30 s each. MTS was measured before and after each set of stretching. Results: A significant two-way interaction (time × sex) was found for MTS (p = 0.021). MTS significantly decreased after one set of stretching in men (p = 0.024) and after three sets in women (p = 0.001). MTS after one and four sets of stretching was significantly higher in men than in women (p = 0.038 and p = 0.019, respectively). Conclusion: Fewer stretching sets are needed for men compared with that required for women to decrease MTS, and the MTS change is greater for men. Thus, the patient's sex should be considered when designing an optimum stretching protocol. [ABSTRACT FROM AUTHOR]

Individuals with cancer are recommended to engage in regular physical activity (PA) even during cancer therapy. The aim of this study was to explore how patient-reported physician PA counseling influences their PA intention and behavior in addition to psycho-cognitive determinants derived from the theory of planned behavior (TPB). A longitudinal study during cancer treatment was conducted among N = 115 patients with breast, prostate, or colorectal cancer (Mage = 58.0, SD = 11.5; 55.7% female). The median time since diagnosis was 2 months, and 19.1% were diagnosed with metastases. Participants provided information on PA counseling by their physicians and on psycho-cognitive variables of the TPB at three measurement points. Additionally, they wore accelerometers for seven days at baseline and three months later. Nearly half of participants (48%) reported basic PA counseling and 30% reported in-depth PA counseling. Patients in poorer health and with lower education reported significantly less in-depth counseling. In addition to patient self-efficacy in performing PA, only in-depth physician PA counseling, but not basic physician counseling, predicted intention for PA four weeks later. Patients' PA three months after baseline was predicted by patients' PA at baseline and their intention for PA. Overall, the PA level at baseline was identified as the most important predictor of PA three months later. Nevertheless, physicians seem to have the ability to increase their cancer patients' intention for PA by in-depth counseling. [ABSTRACT FROM AUTHOR]

Individuals with psychotic disorders often lead sedentary lives, heightening the risk of developing forward head posture. Forward head posture affects upper cervical vertebrae, raising the likelihood of daily discomforts like skeletal misalignment, neck pain, and reduced cardiorespiratory fitness. Improving cardiorespiratory fitness in psychotic disorders is relevant, given its proven benefits in enhancing physical and mental health. This study investigates forward head posture by measuring craniovertebral angles in psychotic disorders and the relationship with reduced cardiorespiratory fitness. To determine whether forward head posture is specific to psychotic disorders, we also included individuals with autism spectrum disorder and healthy controls. Among 85 participants (32 psychotic disorders, 26 autism spectrum disorder, 27 healthy controls), photogrammetric quantification revealed a significantly lower mean craniocervical angle in psychotic disorders compared to autism spectrum disorder (p = < 0.02) and the healthy control group (p = < 0.01). Reduced craniovertebral angle is related to diminished cardiorespiratory fitness in psychosis (R2 = 0.45, p = < 0.01) but not in other control groups. This study found reduced craniovertebral angles, indicating forward head posture in psychotic disorders. Moreover, this relates to diminished cardiorespiratory fitness. Further research is needed to examine the underlying causes and to investigate whether this can be reversed through physical therapy. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to investigate whether there is a difference in pulmonary function between individuals with forward head posture and those with neutral head posture. Methods: A systematic search was conducted using the ResearchGate, PubMed, and Scholar databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The eligibility criteria for the studies were that they investigated the relationship between Forward Head Posture (FHP) and Forced Vital Capacity (FVC) and/or Forced Expiratory Volume in one second (FEV1). Results: A total of four comparison studies and two correlation studies met the inclusion criteria for this study. Across these four studies, encompassing a total of 115 participants, the observed reduction range for FVC was between -0.25 L and -0.81 L, while the reduction values for FEV1 ranged from -0.16 to -0.93 L. According to the results of the correlation studies, a positive correlation was observed between craniovertebral angle (CVA) and dynamic pulmonary volumes. Conclusion: The existing evidence indicates that FHP can potentially cause abnormalities in pulmonary function. In this context, it is suggested that individuals with FHP should be monitored for changes in pulmonary function. [ABSTRACT FROM AUTHOR]

Purpose: The posterior cruciate ligament (PCL) rupture rarely occurs, especially in skeletally immature adolescents, and poses a dilemma in appropriately managing the open physis with its vast growth potential. However, although many epiphyseal-protecting techniques for anterior cruciate ligament (ACL) reconstruction have been reported, a similar problem in PCL reconstruction has received scant attention and needs more relevant research. So, this study aims to evaluate the short-term clinical and imaging results of the arthroscopic physeal-sparing reconstruction program. Method: All the 13 patients we reviewed in this study have accepted the arthroscopic physeal-sparing PCL reconstruction from January 2019 to December 2022 in our Department of Orthopedics. Primary demographic data collected include gender (8 males and 5 females), age (11–15 years, average 13.3 years), follow-up period (15–35 months, average 25.2 months), injury mechanism (nine non-contact injuries and four contact injuries), and days following injury (1–10 days, average 5.3 days). The assessment of clinical outcomes included pre- and postoperative physical examination, knee functional scores, and imaging data. Result: All patients in this study were followed up with an average 25.2-month (range 15–35 months) follow-up period. All the cases preoperatively had a positive posterior drawer test and turned negative at the final follow-up. The average ROM improved from 103.6° ± 11.4° to 132.6° ± 3.6° at the last follow-up (p < 0.05). The VAS score decreased from 5.8 ± 1.6 to 0.9 ± 0.5 (p < 0.05); the average KT-1000 healthy-side to affected-side difference decreased from 11.3 ± 1.6 to1.8 ± 0.5 mm. The comparison of all the knee functional scores (IKDC, Tegner scores, and Lysholm) at preoperative and last follow-up showed a significant difference (p < 0.05). None of the cases had operation-related complications, and all recovered to sports well. Conclusion: The arthroscopic physeal-sparing posterior cruciate ligament reconstruction is a dependable and recommended treatment for posterior cruciate ligament rupture in adolescents with open physis, showing a striking improvement in knee function without growth arrest and angular deformity of the affected limb in the short-term follow-up. [ABSTRACT FROM AUTHOR]

Achilles tendinopathy is a disabling condition that affects more than 50% of runners. Pre-clinical studies in a large animal model of naturally-occurring tendinopathy similar to human Achilles tendinopathy has shown benefits of autologous bone marrow-derived mesenchymal stem cell (MSC) implantation. However, MSCs are advanced therapies medicinal products (ATMPs), with strict regulatory requirements. Guided by the regulator we carried out a first in man study to assess the safety and efficacy of autologous MSC injection in human patients with non-insertional Achilles tendinopathy. Ten patients, mean age 47 with mid-portion Achilles tendon pain and swelling for more than 6 months, underwent autologous cultured cell injections (median 12.2 × 106, range 5–19 × 106 cells) into their Achilles tendon. At 24 weeks follow-up, no serious adverse reactions or important medical events were observed. MOXFQ, EQ-5D-5L, and VISA-A scores improved clinically at 12 and 24 weeks. VAS pain improved increasingly at 6, 12 and 24 weeks. MOXFQ Pain and VISA-A Scores improved > 12 points from baseline to 24 weeks in 8 patients. Maximum anteroposterior tendon thickness as measured by greyscale US decreased by mean 0.8 mm at 24 weeks. This phase IIa study demonstrated the safety of autologous MSC injection for non-insertional Achilles tendinopathy and provides proof-of-concept of the technique in patients, all of whom had previously failed conservative treatments for chronic disease and leads the way for a larger randomised controlled trial. [ABSTRACT FROM AUTHOR]

Background: Chronic ankle instability (CAI) is manifested by sensorimotor impairments in the sprained ankle, including deficits in sensation, motor function, and central integration or processing. These impairments have a significant impact on physical activities and daily life. Recently, some studies have suggested that bilateral deficits were observed in unilateral CAI, but contradictory evidence disputes this finding. Therefore, the objective of this study was to investigate whether bilateral sensorimotor deficits presented in individuals with unilateral CAI. Methods: Without language restriction, the following databases were retrieved from database inception up until 3 November 2023, including PubMed, WOS, EMBASE, Cochrane, SPORTDiscus and CINAHL. Case-control and cross-sectional studies that investigated bilateral sensorimotor functions in individuals with unilateral CAI were included. Sensorimotor functions contained static and dynamic balance, functional performance, muscle strength and activation, as well as sensation. Outcome measures contained centre-of-pressure parameters, normalised reach distance, activation time and magnitude of muscle, sensory errors and threshold. The risk of bias and quality assessment of included studies were evaluated using a standardised tool recommended by the Cochrane Collaboration and the Epidemiological Appraisal Instrument, respectively. To explore the potential bilateral deficits associated with unilateral CAI, a comprehensive meta-analysis was conducted using Review Manager version 5.4. The analysis compared the injured limb of unilateral CAI with healthy controls and the uninjured limb with healthy controls. The main focus of this study was to investigate the differences between the uninjured limb and healthy controls. A random-effects model was employed and effect sizes were estimated using the standardised mean difference (SMD) with 95% confidence intervals (CIs). Effect sizes were deemed as weak (0.2–0.5), moderate (0.5–0.8), or large (> 0.8). Results: A total of 11,442 studies were found; 30 studies were contained in the systematic review and 20 studies were included in the meta-analysis. Compared with healthy controls, those with unilateral CAI presented weak to moderate impairments in their uninjured limbs in static balance with eyes open (SMD = 0.32, 95% CI: 0.08 to 0.56), functional performance (SMD = 0.37; 95% CI: 0.08 to 0.67), kinesthesia (SMD = 0.52; 95% CI: 0.09 to 0.95) and tibialis anterior activation (SMD = 0.60, 95% CI: 0.19 to 1.01). There were no significant differences in other comparisons between the uninjured limb and healthy controls. Conclusions: Patients with unilateral CAI may present bilateral deficits in static balance with eyes open, functional performance and kinaesthesia. However, further evidence is required to confirm this point due to limited studies included in some analyses and small effect size. Registration: The protocol was registered in the International Prospective Register of Systematic Reviews platform (CRD: 42,022,375,855). Key Points This study conducted a meta-analysis to investigate bilateral functions in patients with unilateral chronic ankle instability (CAI). The analysis compared the injured limb of unilateral CAI with healthy control and the uninjured limb with healthy control. Patients with unilateral CAI may present bilateral deficits in static balance with eyes open, functional performance and kinesthesia. However, further large-scale studies are required to validate these findings. In future research, it is crucial to apply bilateral assessment in individuals with unilateral CAI and explore interventions targeting both limbs. Additionally, considering the differences between mechanical and functional ankle instability, future studies could explore the bilateral characteristics based on this classification to gain a better understanding of the variations between the two. This will provide more specific guidance for developing effective training methods. [ABSTRACT FROM AUTHOR]

Background: Change of direction (COD) movements are associated with non-contact anterior cruciate ligament (ACL) injuries in multidirectional sports. Females appear at increased risk compared to males, which could be attributable to whole body kinematic strategies and greater multiplanar knee joint loads (KJLs) during COD which can increase ACL loading. Objective: The aim of this systematic review and meta-analysis was to examine and quantitatively synthesise the evidence for differences between males and females regarding KJLs and their biomechanical determinants (whole body kinematic strategies determining KJLs) during COD tasks. Methods: Databases including SPORTDiscus, Web of Science, and PubMed were systematically searched (July 2021–June 2023) for studies that compared differences in knee joint loads and biomechanical determinants of KJLs during COD between males and females. Inclusion criteria were: (1) females and males with no prior history of ACL injury (18–40 years); (2) examined biomechanical determinants of KJLs and/ or KJLs during COD tasks > 20°; (3) compared ≥ 1 outcome measure between males and females. Studies published between 2000 and 2023 examining a cutting task > 20° with a preceding approach run that compared KJLs or the whole body multiplanar kinematics associated with them, between sexes, using three-dimensional motion analysis. Results: This meta-analysis included 17 studies with a pooled sample size of 451 participants (227 males, 224 females). Meta-analysis revealed females displayed significantly less peak knee flexion during stance (SMD: 0.374, 95% CI 0.098–0.649, p = 0.008, I2: 0%); greater knee abduction at initial contact (IC) (SMD: 0.687, 95% CI 0.299–1.076, p = 0.001, I2: 55%); less hip internal rotation (SMD: 0.437, 95% CI 0.134–0.741, p = 0.005, I2: 34%) and hip abduction at IC (SMD: −0.454, 95% CI 0.151–0.758, p = 0.003, I2: 33%). No significant differences were observed between males and females for any internal or externally applied KJLs. All retrieved studies failed to control for strength, resistance training or skill history status. Conclusion: No differences were observed in KJLs between males and females despite females displaying greater knee abduction at IC and less peak knee flexion during the stance phase of CODs, which are visual characteristics of non-contact ACL injury. Further research is required to examine if this translates to a similar injury risk, considering morphological differences in strain characteristics of the ACL between males and females. This observation may in part explain the disproportionate ACL injury incidence in female multidirectional athletes. Further higher quality controlled research is required whereby participants are matched by skill training history, resistance training history and strength status to ensure an appropriate comparison between males and females. Key Points: No differences between sexes were found for multiplanar KJLs despite previous research supporting this. Further research is required to identify if this is the case and if it affects injury risk between males and females. Females displayed greater knee abduction at initial contact, less peak knee flexion during stance, and less hip rotation and abduction at IC together with less peak hip flexion during stance during CODs. Previous research has failed to account for confounding factors such as skill training history, resistance training history and strength status together with gendered environmental factors that could contribute to the misinterpretation of COD differences between males and females. [ABSTRACT FROM AUTHOR]

Background: One mechanism by which exercise interventions may be effective in reducing anterior cruciate ligament (ACL) injury risk is through changes in lower limb biomechanics. Understanding how training programmes affect lower-limb kinematics and kinetics may help refine injury prevention programmes. Objective: The aim of this systematic review and meta-analysis was to assess the effect of injury prevention programmes on kinematics and kinetics during tasks related to ACL injury in female team field and court sports. Data Sources: Five databases were searched in October 2022. Eligibility Criteria: Randomised controlled trials assessing the effect of injury prevention programmes compared with usual training/no training on lower limb kinematics and kinetics in female team field and court sports were eligible for review. Results: Sixteen studies were included. A total of 976 female athletes were included. Most of the studies included interventions with multiple components (12/16). Commonly used components were plyometrics (12/16), strength (8/16), and balance/stability (7/16). Thirteen studies had routine training or sham interventions as the control group and three studies had no training. Very low certainty evidence suggests that injury prevention programmes increase knee flexion angles (mean difference = 3.1° [95% confidence interval 0.8–5.5]); however, very low to low certainty evidence suggests no effect on hip flexion angles/moments, knee flexion moments, hip adduction angles/moments, knee adduction angles/moments, hip internal rotation angles/moments, ankle dorsiflexion angles, and ground reaction forces, compared with usual training/no training. Conclusion: Injury prevention programmes may be effective in increasing knee flexion angles during dynamic landing and cutting tasks but may have no effect on other lower limb biomechanical variables. As such, the benefits of injury prevention programmes may be mediated by factors other than altered biomechanics and/or may happen through other biomechanical measures not included in this review. [ABSTRACT FROM AUTHOR]

Subjective well-being is an important indicator of adolescents' positive development. Although the general developmental trends of subjective well-being in adolescents have been investigated, the longitudinal differences in the developmental trajectory of subjective well-being in early adolescents remain unclear. This study aimed to explore the developmental trajectory of subjective well-being and examine the predictive roles of gender and parental involvement in this developmental trajectory among Chinese early adolescents. A longitudinal design was used with 2,483 middle students who were followed up across three time points (T1, T2 and T3). The growth mixture model (GMM) analysis showed three subgroups within the developmental trajectory of the subjective well-being of Chinese early adolescents: high-rising (53.3%), moderate-decline (39.7%) and low-decline (7.0%). Furthermore, group membership was predicted by gender, parental academic involvement and parental academic pressure. These findings suggest that it is necessary to implement normative and effective interventions for the different development trajectories of the subjective well-being of early adolescents. [ABSTRACT FROM AUTHOR]

Knee ligament sprains are common during change-of-direction (COD) maneuvers in multidirectional team sports. This study aimed to compare the effects of an 8-week injury prevention exercise program containing COD-specific exercises and a similar program containing linear sprint exercises on injury- and performance-related variables during a 135° COD task. We hypothesized that the COD-specific training would lead to (H1) stronger reductions in biomechanical variables associated with anterior cruciate ligament (ACL) injury risk during COD, i.e. knee abduction moment and angle, hip internal rotation angle and lateral trunk lean, and (H2) more effective improvements in COD performance according to the COD completion time, executed angle, ground contact time, and approach speed. Twenty-two sports science students (40% female) completed biomechanical assessments of COD movement strategies before and after participating in two supervised 25-min training sessions per week over 8 weeks. We observed significant 'training x group' interaction effects in support of H1: the COD-specific training but not the linear sprint training led to reduced peak knee abduction moments (interaction, p = 0.027), initial knee abduction (interaction, p < 0.001), and initial lateral trunk lean angles (interaction, p < 0.001) compared to baseline. Although the COD-specific training resulted in sharper executed angles (interaction, p < 0.001), the sprint-specific training group showed reduced COD completion (interaction, p = 0.037) and ground contact times (interaction, p < 0.001). In conclusion, a combination of generic and COD-specific injury prevention training resulted in COD technique adaptations that can help to avoid ACL injury-prone COD movements but may negatively affect COD speed. [ABSTRACT FROM AUTHOR]

Purpose: There is significant lack on evidence regarding the effect of non-adherence to a recommended protocol in follow-up of high-risk non-muscle-invasive bladder cancer (NMIBC), or the impact of delaying detection of recurrent lesion. Here, we aimed to investigate the optimal frequency of follow-up cystoscopy of high-risk NMIBC with respect to oncological safety in the Japanese real-world clinical practice. Methods: This retrospective single-center study included 206 patients with primary high-risk NMIBC. The intensity (%) of follow-up cystoscopy was calculated based on actual visits for cystoscopy and guideline-recommended frequency in the first 24-month follow-up period. Inverse probability of treatment weighting analyses was used to reduce the risk of bias between groups. We performed a restricted cubic spline analysis with knots at intensity of follow-up cystoscopy ≤ 100% group to examine the possible association of progression risk with the intensity of follow-up as a continuous exposure. Results: The median intensity was 87.5% (interquartile range, 75–100). Adjusted multivariate analysis for MIBC-free and progression-free survival demonstrated no significant difference between adjusted ≤ 75% and > 75% intensity groups. A restricted cubic spline analysis suggested no significant effect of the intensity of follow-up on progression risk, and hazard ratios of patients of < 100% intensity were equivalent to those of patients of 100% intensity. Conclusion: Our finding suggested decreased intensity of follow-up cystoscopy did not affect oncological outcomes in patients with high-risk NMIBC. Further prospective trials directly aimed at investigating optimized follow-up schedules for NMIBC are mandatory before substantial changes to existing clinical guidelines. [ABSTRACT FROM AUTHOR]

Data from previous studies show that YouTube and YouTubers have become an integral part of adolescents' lives and have a significant impact on how adolescents view themselves and the world around them. Previous studies suggest that parasocial relationships with YouTubers are likely to have some characteristics that differ from those with traditional celebrities, such as reciprocity or the illusion of intimacy. The question of this study was why YouTubers are so attractive to adolescents and what are the main components of this attractiveness. A sample of 39 adolescents aged 11 to 20 who were fans of at least one YouTuber participated in focus groups in which we collected data on participants' perceptions of their favourite YouTuber and their YouTuber-related behaviours, expectations, beliefs, and social context. The grounded theory approach was used. The analysis yielded core category "identification" which is a powerful mechanism in adolescent psychology. The core category was supported by four general categories: (1) personal characteristics of YouTubers, (2) characteristics of the relationships between YouTubers and their followers, (3) characteristics related to followers' social context, and (4) characteristics related to the medium itself (e. g. accessibility). Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate internal Achilles tendon (AT) displacement, AT shear wave velocity (SWV), and triceps surae (TS) muscle shear modulus in athletes. Methods: Internal AT displacement was assessed using ultrasound during isometric contraction. Shear wave elastography was used to assess AT SWV (m × s–1) at rest and TS muscle shear modulus (kPa) during passive ankle dorsiflexion. Results: A total of 131 athletes participated in this study. Athletes who had not exercised within two days had greater AT non-uniformity and mean anterior tendon displacement, and lower SWV at the proximal AT measurement site (mean difference [95% CI]: 1.8 mm [0.6–2.9], p = 0.003; 1.6 mm [0.2–2.9], p = 0.021; – 0.9 m × s–1 [– 1.6 to – 0.2], p = 0.014, respectively). Male basketball players had a lower mean AT displacement compared to gymnasts (– 3.7 mm [– 6.9 to – 0.5], p = 0.042), with the difference localised in the anterior half of the tendon (– 5.1 mm [– 9.0 to – 1.1], p = 0.022). Male gymnasts had a smaller absolute difference in medial gastrocnemius-minus-soleus shear modulus than basketball players (59.6 kPa [29.0–90.2], p < 0.001) and track and field athletes (52.7 kPa [19.2–86.3], p = 0.004). Intraclass correlation coefficients of measurements ranged from 0.720 to 0.937 for internal AT displacement, from 0.696 to 0.936 for AT SWE, and from 0.570 to 0.890 for TS muscles. Conclusion: This study provides a reliability assessment of muscle and tendon SWV. The relative differences in passive TS muscle shear modulus suggest sport-specific adaptation. Importantly, in healthy individuals, lower AT displacement after exercise may reflect the time required for tendon recovery. [ABSTRACT FROM AUTHOR]

Purpose: This scoping review was conducted to summarise the outcome tools reported in the assessment of tibial shaft fractures treated with intramedullary (IM) nailing, with a key focus on knee pain and function, and performance-based outcomes. Methods: PubMed and Embase databases were searched on May 31, 2023. All study designs and populations were included, including ex vivo studies without fracture. Studies with only open or intra-articular fractures, or other fracture fixation, were excluded. Reported outcome tools and pertinent study characteristics were extracted and summarised. Results: Of 488 articles identified, 179 met the inclusion criteria. For in vivo studies (n = 152), there were 13,705 fractures; the IM nailing approach not described for 30% of these. There were 133 unique patient outcomes, with a binary assessment of knee pain (29% of studies) and Lysholm score (21%) most common. Only 10/152 (7%) in vivo studies included an objective, performance-based measure of knee function. Fracture union was most frequent (52%) of 81 different clinical outcomes. For ex vivo studies (n = 29), there were 408 tibias included, with nail insertion location most prevalent (66% of studies) of 34 reported outcomes. Conclusion: The heterogeneity of outcome tools reported limits comparison between studies and the most commonly reported patient outcomes may not be the most appropriate. Future studies should report the IM nailing approach and consider capturing both patient-reported and performance-based outcomes to help inform surgical decision making. [ABSTRACT FROM AUTHOR]

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Hematopoietic stem cell transplantation (HSCT) or Bone Marrow Transplantation (BMT) has significantly improved the survival rates of patients suffering from hematological malignancies. However, the cure can only be achieved at the price of morbidity and long-term complications. Thus, this study aimed to evaluate the short-term effect of HSCT on depressive behavior, cognition, and quality of life (QoL) in leukemia patients. Sixty patients were included in this prospective observational study. The current study assessed depression using Patient Health Questionnaire (PHQ-9) scale, cognition using Montreal Cognitive Assessment (MOCA) scale and QoL using European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C30) before 7 days of the therapy i.e., preconditioning/baseline (TP1) and after 30 days of the treatment (TP2) in leukemia patients undergoing HSCT. At TP2, there was a significant improvement in PHQ-9 (p = 0.001), MOCA (p < 0.0001), functional scale (p < 0.0001) and global health & QoL scale (p = 0.001) of EORTC QLQ C30 scores whereas there was a significant decrease in symptom scale of EORTC QLQ C30 score (p = 0.005). Furthermore, at TP2 a statistically significant (p < 0.05) negative correlation was observed between MOCA and symptom scale of EORTC QLQ C30 after Pearson correlation analysis. In conclusion, post-30 days of HSCT there was alleviation in depressive behavior, cognition, and QoL in leukemia patients compared to before therapy. [ABSTRACT FROM AUTHOR]

As contemporary society has become more open, people are treating others with a more tolerant attitude. However, some still exhibit violence and cause harm to gender-nonconforming individuals, with some studies suggesting a positive relationship between gender nonconformity and victimization in recent decades. The current study used a three-level meta-analysis to examine the reliability of the effect size and a series of moderating effects between gender nonconformity and victimization. Based on 81 independent samples (N = 53.183), the effect size obtained in this study was r =.149 (95% CI: [ 0.130, 0.168]), indicating a slight, positive, and significant association between gender nonconformity and victimization. The association between gender nonconformity and verbal victimization was stronger than for other types of victimization; gender nonconformity and victimization were also moderated by bullying members, and their relationship was stronger for peer victimization; whereas the relationship between gender nonconformity and victimization was stronger for men; higher study quality resulted in a stronger association between gender nonconformity and victimization. The above results suggest a significant relationship between gender nonconformity and victimization and point to future research processes that focus on the type of victimization, bullying membership, gender, and study quality in the relationship between the two. [ABSTRACT FROM AUTHOR]

Little is known about changes in the personal living conditions of long-term blood cancer survivors in Germany. To gather information about social relationships, work life, overall well-being, and religion, we performed a questionnaire-based retrospective study on 1551 survivors who had been on follow-up for ≥ 3 years (median, 9 years). Most survivors reported that marital status and relationships with relatives and friends remained constant before and after blood cancer. Vocational activities were temporarily impaired for 47.5%, with a median time of 11 months to return to work. More than a third of the patients (35.6%) discontinued work permanently, with disability and retirement pension rates of 7.9% and 38.1%, respectively, at the time of the survey. Financial problems due to reduced income were reported by 26.2%, in particular after relapse or allogeneic transplantation. Patient reports addressing their quality of life showed large variations. It was best in acute leukemia survivors without a history of allogeneic transplantation and worst in patients with myeloproliferative disorders. Religion tended to become more important after blood cancer. In conclusion, vocational impairment and financial problems are frequent among German blood cancer survivors. Efforts should be made at an early stage to reestablish the patients' ability to work. [ABSTRACT FROM AUTHOR]

A deep understanding of the relationship between self-regulation and role models can enrich the theoretical models that affect the acquisition of self-regulation skills. This study aims to determine the moderating role demographic variables (i.e., gender, grade, and parent's education levels) have on the relationship between middle school students' perceptions of role modeling and their self-regulation. The study uses the explanatory correlation model, a correlational quantitative research design. The sample consists of 1,100 students studying in the 5th, 6th, 7th, and 8th grades of secondary schools during the 2018–2019 academic year. The data have been analyzed using regression analysis in the package program SPSS 25 with the Process Macro plugin. The study has concluded the variables of gender and parents' education levels have a moderating effect on the relationship between secondary school students' perceptions toward role modeling and their self-regulation levels; grade level had no moderating effect. This study indicated that the father's education level had a more moderator effect on this relationship. These results are valuable in terms of revealing that the education level of the mother and father, which is considered the only variable in the studies, should be examined as two separate variables. The relationship between role modeling perceptions and self-regulation can be examined from a broader perspective by considering sociocultural, sociodemographic, and socioeconomic variables. Highlight: Demographic variables such as gender, grade level, and parental education level are generally interpreted using similar statistical analysis methods. We used the SPSS Process macro extension. Thus, we revealed the situation influencing the relationship between the two variables by looking at the demographic variables from a different perspective. [ABSTRACT FROM AUTHOR]

The lumbopelvic muscle mechanical properties (MMPs) are clinically relevant, but their dependence on sex remains unknown. Therefore, this study aimed to identify if lumbopelvic MMPs depend on the sex in a young adult population. Thirty-five healthy nulliparous women and 35 healthy men were analyzed (age range: 18–50). Lumbopelvic MMPs, that is, tone, stiffness, elasticity, relaxation and creep, assessed with MyotonPRO®, and pelvic floor (PF) health questionnaires were compared between-sexes. Intra-group correlations between sociodemographic and clinical data, and MMPs were also determined. The MMPs of PF were different between healthy non-climacteric adults of both sexes, with women showing higher values of tone and stiffness and lower values of elasticity and viscoelastic properties than men (in all cases, p < 0.03). At lumbar level, tone and stiffness were higher for men at both sides (in all cases, p < 0.04), and relaxation was lower at left side (p = 0.02). The MMPs showed few correlations with sociodemographic data within women. However, within males, there were positive correlations for PF stiffness and viscoelastic parameters with age, BMI and function (0.334 < r < 0.591) and, at lumbar level, negative correlations for tone and stiffness (− 0.385 < r < −0.590) and positive correlations for viscoelastic properties (0.564 < r < 0.719), with BMI. This indicated that between-sexes differences of lumbopelvic MMPs depend on the specific location of assessment in healthy non-obese young individuals. Women show higher tone and stiffness and lower elasticity and viscoelasticity than men, at PF level. [ABSTRACT FROM AUTHOR]

Objectives: Neck pain (NP) is associated with substantial disability as well as economic and psychological distress. T1 slope (T1S) and thoracic inlet angle (TIA) reflect cervical sagittal imbalance, which can have clinical/surgical implications. Evidence of the relationship between the sagittal thoracic posture and inlet parameters and pain and functional status is inconclusive. This review aimed to determine whether these parameters differ between NP and pain-free subjects and to critically appraise their correlation with NP measures. Methods: The review consists of 15 studies that evaluated thoracic postural and/or inlet parameters on adult NP patients, after a comprehensive literature search from EBSCO, PubMed, Scopus, Embase, and Web of Science databases. Statistical heterogeneity, mean pooled difference (MPD), and effect size were calculated to establish a relationship among studies and to assess the correlation of thoracic postural and inlet parameters with NP measures, positional variation, and NP predictors. Sensitivity analysis was performed in case of high between-studies heterogeneity. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale. Certainty of evidence was graded using GRADE approach. Results: Only TIA had a significant MPD of 2.12 (0.48, 3.75). The other measures, namely T1S, neck tilt (NT), high thoracic angle, and thoracic kyphosis angle, were not different between NP and asymptomatic subjects. NP population had a 3.14° higher TIA, 4.12° higher NT, and 2.26° lower T1S in lying position (relative to upright). Only thoracic kyphosis and T1S predicted the presence of NP. Very low to low certainty of evidence exists for most of the outcome measures assessed. Conclusion: Limited evidence is available for the association between the sagittal thoracic postural and inlet parameters in nontraumatic cervical dysfunction. Test-position differences reflect marginally lower T1S, and higher TIA, NT in lying than the upright. The existing evidence is insufficient to prove a minor, if any, association of thoracic posture with NP. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the sex-specific association between low knee extensor and flexor muscle strength and the risk of knee structural worsening. Materials and methods: Systematic searches in five databases identified longitudinal studies (≥ 1 year follow-up) reporting an association between knee extensor or flexor strength and structural decline in individuals with, or at risk of, knee osteoarthritis. Results were pooled for tibiofemoral and patellofemoral osteoarthritis worsening (and stratified by sex/gender where possible) using a random-effects meta-analysis estimating the risk ratio and 95% confidence interval or a best-evidence synthesis. Risk of bias and overall certainty of evidence were assessed. Results: Fourteen studies were included with participants (mean age 27–72 years) with osteoarthritis (n = 8), at risk of osteoarthritis (n = 3), or a combination with, or at risk of, osteoarthritis (n = 3). Low knee extensor strength was associated with an increased risk of worsening tibiofemoral (12 studies: RR 1.18, 95% CI 1.04 to 1.35) and patellofemoral osteoarthritis (4 studies: RR 1.62, 95% CI 1.01 to 2.61). Significant associations between low knee extensor strength and worsening tibiofemoral osteoarthritis were observed for women (4 studies: RR 1.25, 95% CI 1.04 to 1.51) but not men (4 studies: RR 1.10, 95% CI 0.87 to 1.39). Low knee flexor strength increased the risk of worsening tibiofemoral osteoarthritis (5 studies: RR 1.16, 95% CI 1.07 to 1.26). Ten studies were high risk of bias, and all estimates were graded as very low certainty of evidence. Conclusion: Low knee extensor and flexor strength increased the risk of worsening tibiofemoral osteoarthritis. Low knee extensor strength increased the risk of worsening patellofemoral osteoarthritis. The relationship between low knee extensor strength and worsening tibiofemoral osteoarthritis may be modified by sex/gender. [ABSTRACT FROM AUTHOR]

The 21st-century world of work complexity is considered a health risk factor for young people. Due to the economic crisis, globalization, and challenges of post-industrial society, 28.8% of Italian young people experience the NEET condition. The study aims to understand the psychological factors associated with the NEET status, specifically the self-perception of transition to adulthood, the future time perspective, and the effects on health in terms of internalizing and externalizing problems. To this end, 450 young people (150 students, 150 employees, 150 NEET) were involved. Moreover, the study has also highlighted that socio-demographic characteristics can play a role in the relationship between the NEET status and these outcomes. The results show that the NEET condition is associated with a negative vision about the future, a low self-perception of transition to adulthood, and internalizing and externalizing health problems. Starting from findings, implications regarding intervention models and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Background: The pivotal role of oxidative stress and inflammation in the pathophysiology of type 2 diabetes mellitus (T2DM) has been firmly established. However, the evidence concerning hypoglycaemic medicinal plants' antioxidant and anti-inflammatory effects remains inconclusive due to inconsistencies in prior studies. To address this gap, our study aims to perform a comprehensive systematic review and meta-analysis of randomized controlled trials (RCTs) to consolidate previous research findings in this field. Methods: We conducted a comprehensive search in the PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases to identify relevant English randomized controlled trials (RCTs). Our study adhered to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. All eligible studies that evaluated concurrently the antioxidative and anti-inflammatory effects of hypoglycaemic plant-derived supplements on type 2 diabetes mellitus (T2DM) were included in the meta-analysis. The meta-analysis itself was carried out using both fixed and random effects models to synthesize the findings from the selected studies. Results: Our study included 47 trials with a total of 2636 participants, both male and female, aged between 20 and 79 years, diagnosed with prediabetes, type 2 diabetes mellitus (T2DM), or metabolic syndrome. The meta-analysis revealed that plant-derived treatments, compared to placebos or other medicines, significantly improved oxidative stress (SMD = − 0.36, 95% CI − 0.64 to − 0.09), inflammation (SMD = − 0.47, 95% CI − 0.63 to − 0.31), total antioxidant capacity (SMD = 0.46, 95% CI 0.16–0.75), and antioxidant enzyme activity (SMD = 1.80, 95% CI 1.26–2.33). The meta-regression analysis showed that treatment duration exceeding 8 weeks significantly impacted the heterogeneity of the oxidative stress data. Conclusions: Several hypoglycaemic plant-based treatments appear to positively affect T2DM patients by concurrently lowering oxidative stress and inflammatory indicators and boosting antioxidant enzyme activity. Clinical Trail Registry: PROSPERO ID: CRD42021226147. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify and evaluate the use of the Patient-Reported Outcomes Measurement Information System in patients with gastrointestinal cancer, as well as provide references for analyzing treatment outcomes, gauging prognostic risk, and assessing clinical symptoms and function in gastrointestinal cancer patients. Methods: PubMed, Web of Science, ProQuest, Embase, and CINAHL were systematically searched using keywords and controlled vocabulary through January 2023. Results: The scoping review collected 30 studies published from 2012 to 2022, including observational studies (n = 21), interventional studies (n = 4), and mixed studies (n = 5). Outcome indicators included mood, pain, fatigue, sleep, the ability to perform activities of daily living, social functioning, and other health problems. Conclusion: Being a self-report questionnaire, the Patient-Reported Outcomes Measurement Information System offers a full assessment of patient’s symptoms and quality of life, and accurately captures their actual thoughts, feelings, and experiences. Individuals with gastrointestinal cancer made frequent use of the Patient-Reported Outcomes Measurement Information System to provide an accurate measure of their health status. [ABSTRACT FROM AUTHOR]

Purpose: This study compared the predictive ability of each independent predictor with that of a combination of predictors for quadriceps strength recovery one year after anterior cruciate ligament (ACL) reconstruction. Methods: Patients who underwent primary ACL reconstruction using hamstring autografts were enrolled. Quadriceps strength, hamstring strength, and anterior tibial translation were measured, and the limb symmetry index (LSI) of the quadriceps and the hamstrings was calculated preoperatively and one year after surgery. Patients were classified into two groups according to the LSI of the quadriceps strength at one year postoperatively (≥ 80% or < 80%). Multivariate logistic regression analysis identified the independent predictors of quadriceps strength recovery, and the cut-off value was calculated using the receiver operating characteristic curve. A model assessing predictive ability of the combination of independent predictors was created, and the area under the curve (AUC) for each independent predictor was calculated by using the receiver-operating characteristic curves and the DeLong method. Results: Of the 646 patients, 414 (64.1%) had an LSI of at least 80% for quadriceps strength one year after surgery, and 232 patients (35.9%) had an LSI of < 80%. Age, sex, body mass index (BMI), preinjury sport level, and LSI of preoperative quadriceps strength were independently associated with quadriceps strength recovery one year after ACL reconstruction. The cut-off values were age: 22.5 years; sex: female; BMI: 24.3 kg/m2; preinjury sport level: no sport; and LSI of preoperative quadriceps strength: 63.3%. The AUC of the model assessing the predictive ability of the combination of age, sex, BMI, preinjury sport level, and LSI of preoperative quadriceps strength was significantly higher (0.73) than that of similar factors of preoperative quadriceps strength (AUC: 0.63, 0.53, 0.56, 0.61, and 0.68, p < 0.01, respectively). Conclusion: The combination of age, sex, BMI, preinjury sport level, and LSI of preoperative quadriceps strength had a superior predictive ability for quadriceps strength recovery at one year after ACL reconstruction than these predictors alone. Multiple factors, including patient characteristics and preoperative quadriceps strength, should be considered when planning rehabilitation programs to improve quadriceps strength recovery after ACL reconstruction. Level of evidence: III. [ABSTRACT FROM AUTHOR]

This study tested whether effects of a preventive intervention delivered in elementary school showed benefits for the young adult offspring of intervention recipients over 20 years later. The Raising Healthy Children (RHC) intervention, trialed in 18 public schools in Seattle, Washington, from 1980–1986 (grades 1–6), sought to build strong bonds to family and school to promote school success and avoidance of substance use and illegal behavior. Four intervention groups were constituted: full, late, parent training only, and control. Participants were followed through 2014 (age 39 years). Those who became parents were enrolled in an intergenerational study along with their oldest offspring (10 assessments between 2002 and 2018). This study includes young adult offspring (ages 18–25 years; n = 169; 52% female; 4% Asian, 25% Black, 40% multiracial, 4% Native American, 2% Native Hawaiian/Pacific Islander, 25% White, and 14% Hispanic/Latinx) of participants in the original RHC trial. Offspring outcome measures included high school noncompletion, financial functioning, alcohol misuse, cannabis misuse, cigarette use, criminal behavior, internalizing behavior, social skills, and social bonding. A global test across all young adult outcome measures showed that offspring of parents who received the full RHC intervention reported better overall functioning compared to offspring of control group parents. Analyses of individual outcomes showed that offspring of full intervention group parents reported better financial functioning than offspring of control group parents. Findings show the potential of universal preventive interventions to provide long-term benefits that reach into the next generation. ClinicalTrials.gov Identifier: NCT04075019; retrospectively registered in 2019. [ABSTRACT FROM AUTHOR]

Background: High tendon strain leads to sub-rupture fatigue damage and net-catabolic signaling upon repetitive loading. While high levels of tendon strain occur in adolescent athletes at risk for tendinopathy, a direct association has not yet been established. Therefore, in this prospective longitudinal study, we examined the hypothesis that adolescent athletes who develop patellar tendon pain have shown increased levels of strain in advance. Methods: In 44 adolescent athletes (12–17 years old), patellar tendon mechanical properties were measured using ultrasonography and inverse dynamics at four time points during a season. Fourteen athletes developed clinically relevant tendon pain (SYM; i.e., reduction of the VISA-P score of at least 13 points), while 23 remained asymptomatic (ASYM; VISA-P score of > 87 points). Seven cases did not fall into one of these categories and were excluded. Tendon mechanical properties of SYM in the session before the development of symptoms were compared to a randomly selected session in ASYM. Results: Tendon strain was significantly higher in SYM compared to ASYM (p = 0.03). The risk ratio for developing symptoms was 2.3-fold higher in athletes with tendon strain ≥9% (p = 0.026). While there was no clear evidence for systematic differences of the force applied to the tendon or tendon stiffness between SYM and ASYM (p > 0.05), subgroup analysis indicated that tendon force increased prior to the development of symptoms only in SYM (p = 0.034). Discussio: The study provides novel longitudinal evidence that high tendon strain could be an important risk factor for patellar tendinopathy in adolescent athletes. We suggest that inadequate adaptation of tendon stiffness to increases in muscle strength may occur if adolescent athletes are subject to mechanical loading which does not provide effective tendon stimulation. [ABSTRACT FROM AUTHOR]

Introduction: Chimeric antigen receptor-T cell (CAR-T) therapy has revolutionized advanced blood cancer treatment. However, preparation, administration, and recovery from these therapies can be complex and burdensome to patients and their care partners. Utilization of an outpatient setting for CAR-T therapy administration could help improve convenience and quality of life. Methods: In-depth qualitative interviews were conducted with 18 patients in the USA with relapsed/refractory multiple myeloma or relapsed/refractory diffuse large B-cell lymphoma, 10 of whom had completed investigational or commercially approved CAR-T therapy and 8 of whom had discussed it with their physicians. We aimed to better understand inpatient experiences and patient expectations regarding CAR-T therapy and to ascertain patient perspectives on the possibility of outpatient care. Results: CAR-T offers unique treatment benefits, particularly high response rates with an extended treatment-free period. All study participants completing CAR-T were very positive about their inpatient recovery experience. Most reported mild-to-moderate side effects; two experienced severe side effects. All said that they would opt to undergo CAR-T therapy again. Participants felt that the primary advantage of inpatient recovery was immediate access to care and on-going monitoring. Perceived advantages of the outpatient setting were comfort and familiarity. Because immediate access to care was seen as crucial, patients recovering in an outpatient setting would seek either a direct contact person or phone line for assistance if needed. Conclusion: As institutions become more experienced with CAR-T therapies, outpatient care may help reduce financial strain. Patient input can help institutions improve the outpatient experience and ensure safety and effectiveness of CAR-T programs. [ABSTRACT FROM AUTHOR]

Purpose: The use of electronic patient-reported outcome (ePRO) data in routine care has been tied to direct patient benefits such as improved quality of care and symptom control and even overall survival. The modes of action behind such benefits are seldom described in detail. Here, we describe the development of a model of care leveraging ePRO data to monitor and manage symptoms of patients treated with immune checkpoint inhibitors. Methods: Development was split into four stages: (1) identification of an underlying theoretical framework, (2) the selection of an ePRO measure (ePROM), (3) the adaptation of an electronic application to collect ePRO data, and (4) the description of an ePRO-oriented workflow. The model of care is currently evaluated in a bicentric longitudinal randomized controlled phase II trial, the IePRO study. Results: The IePRO model of care is grounded in the eHealth Enhanced Chronic Care Model. Patients are prompted to report symptoms using an electronic mobile application. Triage nurses are alerted, review the reported symptoms, and contact patients in case of a new or worsening symptom. Nurses use the UKONS 24-hour telephone triage tool to issue patient management recommendations to the oncology team. Adapted care coordinating procedures facilitate team collaboration and provide patients with timely feedback. Conclusion: This report clarifies how components of care are created and modified to leverage ePRO to enhance care. The model describes a workflow that enables care teams to be proactive and provide patients with timely, multidisciplinary support to manage symptoms. [ABSTRACT FROM AUTHOR]

Purpose: Investigating the use of the EORTC bladder cancer (BC) modules by evaluating: (a) study contexts/designs; (b) languages/countries in which the modules were administered; (c) their acceptance by patients/investigators; and (d) their psychometric properties. Methods: A systematic review was performed with studies from 1998 until 20/10/2021 in five databases. Articles/conference abstracts using the EORTC-QLQBLM30 (muscle invasive BC) and the EORTC-QLQNMIBC24 (previously referred to as QLQ-BLS24; non-muscle invasive BC) were included. Two authors independently screened titles/abstracts/full-texts and performed data extraction. Results: A total of 76 eligible studies were identified. Most studies included the BLM30 (n = 53), were in a urological surgery context (n = 41) and were cross-sectional (n = 35) or prospective (n = 30) in design. The BC modules were administered in 14 languages across 19 countries. Missing data were low-moderate for all non-sex related questions (< 1% to 15%). Sex-related questions had higher rates of missing data (ranging from 6.9% to 84%). Most investigators did not use all scales of the questionnaires. One validation study for the original BLS24 led to the development of the NMIBC24, which adopted a new scale structure for which good structural validity was confirmed (n = 3). Good reliability and validity was shown for the NMIBC24 module, except for malaise and bloating/flatulence scales. Psychometric evidence for BLM30 is lacking. Conclusion: These results provide insight into how the EORTC BC quality of life modules could be further improved. Current work is ongoing to update the modules and to determine if the two modules can be combined into a single questionnaire that works well in both the NMIBC and MIBC settings. [ABSTRACT FROM AUTHOR]

Achilles' tendon (AT) injuries such as ruptures and tendinopathies have experienced a dramatic rise in the mid- to older-aged population. Given that the AT plays a key role at all stages of locomotion, unsuccessful rehabilitation after injury often leads to long-term, deleterious health consequences. Understanding healthy in vivo strains as well as the complex muscle–tendon unit interactions will improve access to the underlying aetiology of injuries and how their functionality can be effectively restored post-injury. The goals of this survey of the literature with a systematic search were to provide a benchmark of healthy AT strains measured in vivo during functional activities and identify the sources of variability observed in the results. Two databases were searched, and all articles that provided measured in vivo peak strains or the change in strain with respect to time were included. In total, 107 articles that reported subjects over the age of 18 years with no prior AT injury and measured while performing functional activities such as voluntary contractions, walking, running, jumping, or jump landing were included in this review. In general, unclear anatomical definitions of the sub-tendon and aponeurosis structures have led to considerable confusion in the literature. MRI, ultrasound, and motion capture were the predominant approaches, sometimes coupled with modelling. The measured peak strains increased from 4% to over 10% from contractions, to walking, running, and jumping, in that order. Importantly, measured AT strains were heavily dependent on measurement location, measurement method, measurement protocol, individual AT geometry, and mechanical properties, as well as instantaneous kinematics and kinetics of the studied activity. Through a comprehensive review of approaches and results, this survey of the literature therefore converges to a united terminology of the structures and their common underlying characteristics and presents the state-of-knowledge on their functional strain patterns. [ABSTRACT FROM AUTHOR]

Sitting balance is an important aspect of overall motor control, particularly for individuals who are not able to stand. Typical clinical assessment methods for sitting balance rely on human observation, making them subjective, imprecise, and sometimes time-consuming. The primary objective of this study is to develop an improved system for assessing sitting balance in clinical settings. We designed a software tool that takes input from an RGB-D camera system to track human movement during sitting balance assessment. We validated the system by tracking subject's movements during two seated balance exercises. To assess the accuracy of our system's measurements, we compared them with measurements taken using a ruler and measurements captured from still images from a video recording. The agreement of body angle measurement was an average of 2.19 ± 2.29 degrees, and agreement of forward reach distance was an average of 0.1 ± 0.25 in.. The results show that our approach can track a person's body movements with clinically relevant accuracy, suggesting that this RGB-D camera-based system could offer advantages over existing observational methods of sitting balance assessment. [ABSTRACT FROM AUTHOR]

Summary: Background: The incidence and the comorbidities, such as infectious diseases (e.g. pneumonia or influenza) of diabetes mellitus are increasing. Therefore, the purpose of this study is to investigate immunization status and preventive care in diabetes mellitus patients. Methods: Two groups from the Austrian health interview survey 2014 were identified, a cohort of diabetes mellitus (DM) individuals (n = 678) and a non-diabetes mellitus (non-DM) cohort (n = 15,093). The frequencies of doctors' visits, preventive care and immunization status were compared. Furthermore, the study population was divided by age (> 50 years, < 50 years) and differences between > 50 years old DM with < 50 years old DM and the > 50 years old DM and > 50 years old Non-DM cohort were investigated. Results: In the DM cohort a higher frequency of influenza immunization (13.3% vs. 7.1%, p < 0.001), doctor visits (89.4% vs. 75.4%, p < 0.001), and preventive care, such as colonoscopy (11.2% vs. 6.8%, p < 0.001) and hemoccult tests (32.6% vs. 22.1%, p < 0.001) was observed. Even though older DM individuals have a higher risk for complications, the > 50 years DM cohort has similar frequencies of colonoscopy, hemoccult test and immunization against influenza and TBE (tick-borne encephalitis) compared to > 50 years Non-DM. Although the > 50 years old DM cohort had a higher frequency of doctors' visits, they still had lower frequencies of mammography and dentists' visits compared to > 50 years old Non-DM. In comparison to the < 50 years old DM cohort, the > 50 years DM cohort was related to lower intact immunization status of tetanus, diphtheria, Polio and TBE. Still a higher frequency of intact immunization of pneumococcus, influenza and doctors' visits in the > 50 years old DM cohort compared to the < 50 years old DM cohort can be reported. Conclusion: Preventive care and immunization status in the DM cohort just differ slightly from the general cohort but still should be improved. [ABSTRACT FROM AUTHOR]

Background: Lateral ankle sprains are the most common ankle injuries in sports and have the highest recurrence rates. Almost half of the patients experiencing lateral ankle sprains develop chronic ankle instability. Patients with chronic ankle instability experience persistent ankle dysfunctions and detrimental long-term sequelae. Changes at the brain level are put forward to explain these undesirable consequences and high recurrence rates partially. However, an overview of possible brain adaptations related to lateral ankle sprains and chronic ankle instability is currently lacking. Objective: The primary purpose of this systematic review is to provide a comprehensive overview of the literature on structural and functional brain adaptations related to lateral ankle sprains and in patients with chronic ankle instability. Methods: PubMed, Web of Science, Scopus, Embase, EBSCO—SPORTDiscus and Cochrane Central Register of Controlled Trials were systematically searched until 14 December, 2022. Meta-analyses, systematic reviews and narrative reviews were excluded. Included studies investigated functional or structural brain adaptations in patients who experienced a lateral ankle sprain or with chronic ankle instability and who were at least 18 years of age. Lateral ankle sprains and chronic ankle instability were defined following the recommendation of the International Ankle Consortium. Three authors independently extracted the data. They extracted the authors' name, publication year, study design, inclusion criteria, participant characteristics, the sample size of the intervention and control groups, methods of neuroplasticity testing, as well as all means and standard deviations of primary and secondary neuroplasticity outcomes from each study. Data reported on copers were considered as part of the control group. The quality assessment tool for observational and cross-sectional studies was used for the risk of bias assessment. This study is registered on PROSPERO, number CRD42021281956. Results: Twenty articles were included, of which only one investigated individuals who experienced a lateral ankle sprain. In all studies combined, 356 patients with chronic ankle instability, 10 who experienced a lateral ankle sprain and 46 copers were included. White matter microstructure changes in the cerebellum have been related to lateral ankle sprains. Fifteen studies reported functional brain adaptations in patients with chronic ankle instability, and five articles found structural brain outcomes. Alterations in the sensorimotor network (precentral gyrus and supplementary motor area, postcentral gyrus and middle frontal gyrus) and dorsal anterior cingulate cortex were mainly found in patients with chronic ankle instability. Discussion: The included studies demonstrated structural and functional brain adaptations related to lateral ankle sprains and chronic ankle instability compared to healthy individuals or copers. These adaptations correlate with clinical outcomes (e.g. patients' self-reported function and different clinical assessments) and might contribute to the persisting dysfunctions, increased re-injury risk and long-term sequelae seen in these patients. Thus, rehabilitation programmes should integrate sensorimotor and motor control strategies to cope with neuroplasticity related to ligamentous ankle injuries. [ABSTRACT FROM AUTHOR]

Background: Virtual mirror therapies could increase the results of exercise, since the mirror neuron system produces an activation of motor execution cortical areas by observing actions performed by others. In this way, pre-frail and frail people could use this system to reach an exercise capacity threshold and obtain health benefits. Aim: The aim of this study is to evaluate the effects of a virtual running (VR) treatment combined with specific physical gait exercise (PE) compared to placebo VR treatment combined with PE on functionality, pain, and muscular tone in pre-frail and frail older persons. Methods: A single blinded, two-arm, randomised controlled trial design was employed. Thirty-eight participants were divided into two intervention arms: Experimental Intervention (EI) group, in which VR and gait-specific physical exercises were administered and Control Intervention (CI) group, in which a placebo virtual gait and the same exercise programme was administered. Functionality, pain, and tone were assessed. Results: EI group improved in aerobic capacity, functional lower-limb strength, reaction time, and pain, while CI group remained the same. Regarding static balance and muscle tone, no differences were found for either group. Further analysis is needed to asses VR effectiveness for improving gait, stand-up and sit-down performance and velocity. Conclusions: Virtual running therapy appears to enhance capacities related with voluntary movements (i.e., aerobic capacity, functional lower-limb strength, and reaction time) and reduce pain. [ABSTRACT FROM AUTHOR]

Purpose of Review: The number of older adults with cancer relying on support from caregivers continues to increase. Health disparities in older adults with cancer often extend to their caregivers. This review aims to assess the state of cancer caregiving research in historically underrepresented diverse populations and provide recommendations for future research and policy. Recent Findings: Research on caregivers of older adults with cancer from diverse backgrounds has primarily been descriptive. Health disparities for historically underrepresented caregivers (LGBTQ + , BIPOC, rural, young adults, youth) exist across several dimensions (e.g., financial, mental, and physical health, and access to caregiver support). Few published studies have closely examined the unique experiences of these caregivers nor provided culturally appropriate tailored interventions. Summary: Health equity research within caregiving populations is in its infancy. Priorities for future work should focus on identifying modifiable targets for intervention, changing systems-level processes in acknowledging and supporting caregivers, and creating policies that reduce financial inequities of caregiving. [ABSTRACT FROM AUTHOR]

Background: Research shows that feeding back patient-reported outcome information to clinicians and/or patients could be associated with improved care processes and patient outcomes. Quantitative syntheses of intervention effects on oncology patient outcomes are lacking. Objective: To determine the effects of patient-reported outcome measure (PROM) feedback intervention on oncology patient outcomes. Data sources: We identified relevant studies from 116 references included in our previous Cochrane review assessing the intervention for the general population. In May 2022, we conducted a systematic search in five bibliography databases using predefined keywords for additional studies published after the Cochrane review. Study selection: We included randomized controlled trials evaluating the effects of PROM feedback intervention on processes and outcomes of care for oncology patients. Data extraction and synthesis: We used the meta-analytic approach to synthesize across studies measuring the same outcomes. We estimated pooled effects of the intervention on outcomes using Cohen's d for continuous data and risk ratio (RR) with a 95% confidence interval for dichotomous data. We used a descriptive approach to summarize studies which reported insufficient data for a meta-analysis. Main outcome(s) and measures(s): Health-related quality of life (HRQL), symptoms, patient-healthcare provider communication, number of visits and hospitalizations, number of adverse events, and overall survival. Results: We included 29 studies involving 7071 cancer participants. A small number of studies was available for each metanalysis (median = 3 studies, ranging from 2 to 9 studies) due to heterogeneity in the evaluation of the trials. We found that the intervention improved HRQL (Cohen's d = 0.23, 95% CI 0.11–0.34), mental functioning (Cohen's d = 0.14, 95% CI 0.02–0.26), patient-healthcare provider communication (Cohen's d = 0.41, 95% CI 0.20–0.62), and 1-year overall survival (OR = 0.64, 95% CI 0.48–0.86). The risk of bias across studies was considerable in the domains of allocation concealment, blinding, and intervention contamination. Conclusions and relevance: Although we found evidence to support the intervention for highly relevant outcomes, our conclusions are tempered by the high risk of bias relating mainly to intervention design. PROM feedback for oncology patients may improve processes and outcomes for cancer patients but more high-quality evidence is required. [ABSTRACT FROM AUTHOR]

In alpine skiing, estimation of the muscle forces and joint loads such as the forces in the ACL of the knee are essential to quantify the loading pattern of the skier during turning maneuvers. Since direct measurement of these forces is generally not feasible, non-invasive methods based on musculoskeletal modeling should be considered. In alpine skiing, however, muscle forces and ACL forces have not been analyzed during turning maneuvers due to the lack of three dimensional musculoskeletal models. In the present study, a three dimensional musculoskeletal skier model was successfully applied to track experimental data of a professional skier. During the turning maneuver, the primary activated muscles groups of the outside leg, bearing the highest loads, were the gluteus maximus, vastus lateralis as well as the medial and lateral hamstrings. The main function of these muscles was to generate the required hip extension and knee extension moments. The gluteus maximus was also the main contributor to the hip abduction moment when the hip was highly flexed. Furthermore, the lateral hamstrings and gluteus maximus contributed to the hip external rotation moment in addition to the quadratus femoris. Peak ACL forces reached 211 N on the outside leg with the main contribution in the frontal plane due to an external knee abduction moment. Sagittal plane contributions were low due to consistently high knee flexion (> 60 ∘ ), substantial co-activation of the hamstrings and the ground reaction force pushing the anteriorly inclined tibia backwards with respect to the femur. In conclusion, the present musculoskeletal simulation model provides a detailed insight into the loading of a skier during turning maneuvers that might be used to analyze appropriate training loads or injury risk factors such as the speed or turn radius of the skier, changes of the equipment or neuromuscular control parameters. [ABSTRACT FROM AUTHOR]

Objective: Exercise during and after cancer treatment has established quality of life and health benefits. However, particularly for patients with hematological cancer clear recommendations regarding the safety and feasibility of exercise are under-investigated. The aim of our systematic review was to summarize the literature regarding the feasibility and safety of exercise interventions in patients diagnosed with hematological cancer undergoing chemotherapy. Method: A systematic literature review was conducted using PubMed, SPORTDiscus, MEDLINE, Science Direct, and Web of Science electronic databases. Eligible studies were scientific publications reporting the feasibility and/or safety of an exercise intervention program carried out in inpatient patients diagnosed with hematological cancer undergoing chemotherapy. Result: Out of 12 studies (six RCTs) included in this review, six investigations reported results with regard to safety and 10 with regard to feasibility. While all studies claim that their exercise interventions were safe and/or feasible, it is noteworthy that this claim often remains unsupported as detailed information on how the feasibility of the intervention was asserted is missing. Conclusion: Exercise appears to be safe and feasible in hematological cancer patients. However, due to a striking lack of information on how the feasibility of the intervention was asserted, contextualizing the results and deducing recommendations for further studies remains challenging. Further research should therefore incorporate information on the execution of the exercise intervention in more detail. [ABSTRACT FROM AUTHOR]

Background: Italy was one of the first European countries to be affected by Covid-19. Due to the severity of the pandemic, the Italian government imposed a nationwide lockdown which had a great impact on the population, especially adolescents. Distance-learning, moving restrictions and pandemic-related concerns, resulted in a particularly stressful situation. Objective: This cross-sectional study aims to analyse substance consumption and its associated factors during the Covid-19 lockdown imposed by the Italian government. Methods: ESPAD is a questionnaire that is administered yearly in Italian high schools. In 2020, it was administered online during dedicated hours of distance learning, collecting data from 6027 Italian students (52.4% were male) aged 15–19. Data collected from the 2020 questionnaire was matched with that collected in 2019, in order to make them comparable. Results: The prevalence of consumption of each substance decreased during the restriction period, and the most used substance during the lockdown period was alcohol (43.1%). There were some changes in factors associated with psychoactive substance use, especially painkillers and non-prescription drugs. For instance, unlike what was observed in the 2019 model, in 2020 spending money without parental control was associated with painkillers and non-prescription drug use while risk perception was not. Conclusions: The restrictions and the increased difficulties in obtaining psychoactive substances did not prevent their consumption, and students with particular risk factors continued to use them, possibly changing the substance type of substance. This information is useful in order to better understand adolescents' substance use during the ongoing pandemic. [ABSTRACT FROM AUTHOR]